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1. Austin RM, Onisko A, Druzdzel MJ: The Pittsburgh Cervical Cancer Screening Model: a risk assessment tool. Arch Pathol Lab Med; 2010 May;134(5):744-50
International Agency for Research on Cancer - Screening Group. diagnostics - A practical manual on visual screening for cervical neoplasia .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The Pittsburgh Cervical Cancer Screening Model: a risk assessment tool.
  • CONTEXT: Evaluation of cervical cancer screening has grown increasingly complex with the introduction of human papillomavirus (HPV) vaccination and newer screening technologies approved by the US Food and Drug Administration.
  • OBJECTIVE: To create a unique Pittsburgh Cervical Cancer Screening Model (PCCSM) that quantifies risk for histopathologic cervical precancer (cervical intraepithelial neoplasia [CIN] 2, CIN3, and adenocarcinoma in situ) and cervical cancer in an environment predominantly using newer screening technologies.
  • DESIGN: The PCCSM is a dynamic Bayesian network consisting of 19 variables available in the laboratory information system, including patient history data (most recent HPV vaccination data), Papanicolaou test results, high-risk HPV results, procedure data, and histopathologic results.
  • RESULTS: The PCCSM compares risk quantitatively over time for histopathologically verifiable CIN2, CIN3, adenocarcinoma in situ, and cervical cancer in screened patients for each current cytology result category and for each HPV result.
  • Prior history also alters the CIN2, CIN3, adenocarcinoma in situ, and cervical cancer risk for patients with common current cytology and HPV test results.
  • The PCCSM can also generate negative risk projections, estimating the likelihood of the absence of histopathologic CIN2, CIN3, adenocarcinoma in situ, and cervical cancer in screened patients.
  • CONCLUSIONS: The PCCSM is a dynamic Bayesian network that computes quantitative cervical disease risk estimates for patients undergoing cervical screening.
  • Continuously updatable with current system data, the PCCSM provides a new tool to monitor cervical disease risk in the evolving postvaccination era.
  • [MeSH-major] Adenocarcinoma / diagnosis. Cervical Intraepithelial Neoplasia / diagnosis. Early Detection of Cancer / methods. Uterine Cervical Neoplasms / diagnosis
  • [MeSH-minor] Female. Humans. Papanicolaou Test. Papillomavirus Infections / diagnosis. Risk Assessment. Risk Factors. Vaginal Smears

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  • (PMID = 20441506.001).
  • [ISSN] 1543-2165
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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2. Miller B, Dunn J, Dalrymple J, Krivak TC: Pelvic sidewall adenocarcinoma after definitive therapy for cervical adenocarcinoma in situ. Gynecol Oncol; 2005 Nov;99(2):489-92
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pelvic sidewall adenocarcinoma after definitive therapy for cervical adenocarcinoma in situ.
  • BACKGROUND: Traditionally, hysterectomy is considered definitive therapy for cervical adenocarcinoma in situ (AIS) in women beyond childbearing.
  • CASE: A 45-year-old gravida 2, para 2 patient presented with cervical dysplasia and on pathology review of the large loop excision procedure cervical adenocarcinoma in situ was diagnosed.
  • Final pathology revealed adenocarcinoma in situ with negative margins.
  • A CT-guided biopsy of the mass was consistent with invasive adenocarcinoma of the endocervical type.
  • CONCLUSION: This case depicts another example of the unpredictable nature of cervical AIS.
  • Despite undergoing definitive surgery, a residual focus of disease may remain leading to invasive adenocarcinoma.
  • Close follow-up is required of all patients diagnosed with AIS because the disease is poorly understood.
  • [MeSH-major] Adenocarcinoma / pathology. Adenocarcinoma / surgery. Carcinoma in Situ / surgery. Pelvic Neoplasms / pathology. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Female. Humans. Hysterectomy. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / radiotherapy

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  • (PMID = 16054200.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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3. Zielinski GD, Snijders PJ, Rozendaal L, Daalmeijer NF, Risse EK, Voorhorst FJ, Jiwa NM, van der Linden HC, de Schipper FA, Runsink AP, Meijer CJ: The presence of high-risk HPV combined with specific p53 and p16INK4a expression patterns points to high-risk HPV as the main causative agent for adenocarcinoma in situ and adenocarcinoma of the cervix. J Pathol; 2003 Dec;201(4):535-43
NCI CPTAC Assay Portal. NCI CPTAC Assay Portal .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The presence of high-risk HPV combined with specific p53 and p16INK4a expression patterns points to high-risk HPV as the main causative agent for adenocarcinoma in situ and adenocarcinoma of the cervix.
  • Adenocarcinoma in situ (ACIS) and adenocarcinoma (AdCA) of the cervix are frequently missed in population-based screening programmes.
  • Adding high-risk HPV (hrHPV) testing to cervical cancer screening might improve the detection rate of ACIS and AdCA.
  • Since the exact proportion of AdCAs of the cervix that can be attributed to hrHPV infection is still a matter of debate, a comprehensive study was performed of hrHPV presence in ACIS and AdCA of the cervix.
  • Archival formalin-fixed specimens of indisputable ACIS (n=65) and AdCA (n=77) of the cervix were tested for hrHPV DNA by GP5+/6+ PCR-enzyme immunoassay (EIA) and type-specific E7 PCR for 14 hrHPV types.
  • Further immunostaining for p16INK4A and p53 was performed to assess alternative pathways of carcinogenesis potentially unrelated to HPV. hrHPV DNA was found in all (100%) ACISs and 72 (94%) cervical AdCAs, whereas none of 20 endometrial AdCAs scored hrHPV-positive.
  • HPV 18 was most prevalent and found as single or multiple infection in 68% of ACISs and 55% of cervical AdCAs.
  • Diffuse immunostaining for p16INK4a, a potential marker of hrHPV E7 function, was significantly more frequent in hrHPV-positive cervical AdCAs (19/20; 95%) than in those without hrHPV (1/5; 20%; p<0.001).
  • Immunostaining for p53, pointing to stabilized wild-type or mutant p53 protein, was significantly more frequent in hrHPV cervical AdCAs negative for hrHPV (p=0.01).
  • No difference in p16INK4a and p53 immunostaining was found between hrHPV-negative cervical AdCAs and endometrial AdCAs.
  • Hence, only a minority of cervical AdCAs displayed absence of HPV DNA and immunostaining profiles suggestive of an aetiology independent of HPV.
  • Since all ACISs and nearly all cervical AdCAs were hrHPV-positive, the incorporation of hrHPV testing in cervical cancer screening programmes is likely to decrease markedly the incidence of cervical AdCA.
  • [MeSH-major] Adenocarcinoma / etiology. Carcinoma in Situ / etiology. Papillomaviridae / genetics. Papillomavirus Infections / complications. Uterine Cervical Neoplasms / etiology

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  • [Copyright] Copyright 2003 John Wiley & Sons, Ltd.
  • (PMID = 14648656.001).
  • [ISSN] 0022-3417
  • [Journal-full-title] The Journal of pathology
  • [ISO-abbreviation] J. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DNA, Neoplasm; 0 / DNA, Viral
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4. Dede M, Gezginç K, Ulubay M, Alanbay I, Güran S, Yenen M: A breast cancer patient with pelvic and gastric malignancy after adjuvant tamoxifen treatment for breast cancer. Eur J Gynaecol Oncol; 2008;29(2):200
Hazardous Substances Data Bank. TAMOXIFEN .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • As is known, tamoxifen therapy is related to endometrial proliferation, hyperplasia, polyp formation, invasive carcinoma and uterine sarcoma.
  • Gastric tumor, endometrial carcinoma and cervical adenocarcinoma in situ were detected after treatment with tamoxifen for breast cancer.
  • [MeSH-major] Breast Neoplasms / drug therapy. Selective Estrogen Receptor Modulators / adverse effects. Tamoxifen / adverse effects
  • [MeSH-minor] Adenocarcinoma / chemically induced. Aged. Carcinoma in Situ / chemically induced. Endometrial Neoplasms / chemically induced. Female. Humans. Middle Aged. Stomach Neoplasms / chemically induced. Uterine Cervical Neoplasms / chemically induced

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  • (PMID = 18459568.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Selective Estrogen Receptor Modulators; 094ZI81Y45 / Tamoxifen
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5. Dekker AH: Fostering acceptance of human papillomavirus vaccines. J Am Osteopath Assoc; 2006 Mar;106(3 Suppl 1):S14-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Fostering acceptance of human papillomavirus vaccines.
  • Multivalent prophylactic human papillomavirus (HPV) vaccines currently in the late stages of clinical testing are safe, immunogenic, and efficacious; and phase 3 tests of a quadrivalent vaccine show that it is 100% effective at preventing HPV types 16 and 18-associated cervical intraepithelial neoplasia grades 2 and 3, adenocarcinoma in situ, and cervical cancer through 2 years of postvaccination follow-up.
  • These vaccines promise to reduce the burden of HPV-related disease.
  • Realizing the full benefit of these vaccines will require a vaccination program that addresses the needs and concerns of healthcare providers, parents, and young adolescent patients who will be involved in the vaccine decisionmaking process.
  • Osteopathic physicians, by virtue of their dedication to holistic care, are in an optimal position to play a key role in facilitating acceptance of these vaccines among potential vaccinees and their parents and guardians.
  • [MeSH-major] Papillomaviridae / immunology. Papillomavirus Infections / prevention & control. Papillomavirus Vaccines. Patient Acceptance of Health Care. Viral Vaccines
  • [MeSH-minor] Adolescent. Adult. Attitude of Health Personnel. Drug Costs. Female. Health Knowledge, Attitudes, Practice. Humans. Male

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  • (PMID = 16729556.001).
  • [ISSN] 0098-6151
  • [Journal-full-title] The Journal of the American Osteopathic Association
  • [ISO-abbreviation] J Am Osteopath Assoc
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Papillomavirus Vaccines; 0 / Viral Vaccines
  • [Number-of-references] 18
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